Fresenius Medical Care Ag · XETR:FME
Fresenius Medical Care — Q4 2025 Earnings Presentation
38 slides from Fresenius Medical Care's earnings presentation, Feb 24, 2026
Slide 1: Q4/FY 2025 Earnings Call
Helen Giza CEO & Chair of the Management Board Martin Fischer CFO February 24, 2026 Q4/FY 2025 Earnings Call
Slide 2: Safe harbor statement
Safe harbor statement: In this Safe harbor statement, “the Company” and “Fresenius Medical Care” refer to Fresenius Medical Care AG & Co. KGaA, a German partnership limited by shares, prior to its conversion of legal form, and to Fresenius Medical Care AG, a German stock corporation, after its conve
Slide 3: Strategic progress in 2025, Q4 2025 business update, Outlook
1 Strategic progress in 2025 2 Q4 2025 business update 3 Outlook
Slide 4: 2025 | FME Reignite – Next phase of Value Creation
2025 | FME Reignite – Next phase of Value Creation Q4 2024 Conference Call New Value- Soft launch of Step-up in Based Care 5008X U.S. operating segment roll-out income margin Further refinement of Select pilot programs Supported by all 3 operating model, in FME clinics to segments and enhancing repo
Slide 5: 2025 | Significant step-up in profitability achieved
2025 | Significant step-up in profitability achieved Q4 2024 Conference Call Outlook FY 2025 Positive to a low-single Revenue digit percent growth +5% FY 2024 basis: € 19,336 million FY 2025: € 19,628 million High-teens to high- Operating income twenties percent growth +27% FY 2024 basis: € 1,797 mi
Slide 6: 2025 mid-term financial targets | Committed. Delivered.
2025 mid-term financial targets | Committed. Delivered. Q4 2024 Conference Call Key financial target 2025 mid-term target2 vs. actuals 2022 2025 Group Operating income margin1 % Group target 10-14% 7.9% 11.3% Operating income margin1 Care Delivery target 11-15% 9.5% 13.1% Care Delivery2 Care Enablem
Slide 7: 2025 mid-term financial targets | Committed. Delivered.
2025 mid-term financial targets | Committed. Delivered. Q4 2024 Conference Call Key strategic initiative 2025 target vs. actuals Accumulated sustainable savings of € 750 million FME25+ ▪ 2025 mid-term target of €750 million by 2025 transformation program ▪ Exceeded: €804 million Exit international m
Slide 8: 2025 | Strong cash generation drives capital return to shareholders
2025 | Strong cash generation drives capital return to shareholders Conference Q4 2024 Call Capital allocation Capital return to shareholders Invested €0.9bn in core business for profitable growth Dividend1 €1.49 +3% or 33% of adjusted net income in Shareholder line with dividend policy of 30-40% €2
Slide 9: Strategic progress in 2025, Q4 2025 business update, Outlook
1 Strategic progress in 2025 2 Q4 2025 business update 3 Outlook
Slide 10: Q4 2025 | Exceptional financial performance capping a milestone year
Q4 2025 | Exceptional financial performance capping a milestone year Q4 2024 Conference Call ▪ Strong organic revenue growth¹ of +8.2% driven by Q4 Value-Based Care and Care Delivery ▪ Significant operating income² growth of 53% and operating income margin² expansion by 430 bps to 13.9% ▪ FME25+ pro
Slide 11: Q4 2025 Highlights | Strong execution accelerates operational improvements
Q4 2025 Highlights | Strong execution accelerates operational improvements Q4 2024 Conference Call Care Value-Based Care Delivery Care Enablement ▪ Same market treatment growth: ▪ Positive operating income¹ driven by ▪ Overall positive pricing contribution – U.S. broadly flat favorable savings rate,
Slide 12: Q4 2025 | Strong organic revenue and accelerated earnings growth
Q4 2025 | Strong organic revenue and accelerated earnings growth Conference Q4 2024 Call Revenue | in € million Operating income | in € million Margin in % +7.1% at cc¹ 5.1% 9.6% 13.9% 11.7% 5,085 +8.2% organic2 5,070 -0.3% as reported +52.9% at cc1 +44.2% 705 at current rate 594 230 489 -111 259 Q4
Slide 13: Q4 2025 | Significant step up in operating income driven by Care Delivery
Q4 2025 | Significant step up in operating income driven by Care Delivery Q4 2024 Conference Call Margin in % 9.6% 13.9% In € million 31 5 37 705 193 -7 -43 594 -111 230 489 259 Q4 2024 Special items Q4 2024 Care Value-Based Care Inter- Corporate Fx Q4 2025 Special items Q4 2025 operating operating
Slide 14: Q4 2025 | Care Delivery delivers highly profitable growth
Q4 2025 | Care Delivery delivers highly profitable growth Q4 2024 Conference Call Revenue | in € million Operating income | in € million Margin in % 12.0% +33.7% 16.4% +5.7% at cc¹ at current rate 3,571 +7.3% organic2 3,507 -1.8% as reported +44.9% at cc1 255 26 574 2,985 2,956 -88 430 -49 U.S. Inte
Slide 15: Q4 2025 | Value-Based Care achieves positive operating income
Q4 2025 | Value-Based Care achieves positive operating income Q4 2024 Conference Call Revenue | in € million Operating income | in € million +42.4% at cc¹ Margin in % n.a. -1.4% at current rate 4.5% +42.4% organic2 637 +31.6% as reported 484 n.a.1 29 2 -1 -1 36 -7 Q4 2024 Business FME25+ Inflation F
Slide 16: Q4 2025 | Care Enablement maintains stable operating income margin
Q4 2025 | Care Enablement maintains stable operating income margin Q4 2024 Conference Call Revenue | in € million Operating income | in € million Margin in % 7.7% 7.7% -3.2% at cc¹ -8.6% at current rate 1,537 -8.8% as reported -3.2% organic2 1,401 -5.8% at cc1 42 118 107 -18 -4 -31 Q4 2024 Q4 2025 Q
Slide 17: Q4 2025 | Strong operating cash-flow | low end of leverage target corridor
Q4 2025 | Strong operating cash-flow | low end of leverage target corridor Q4 2024 Conference Call in € million Q4 2025 Q4 2024 ∆ in % FY 2025 FY 2024 ∆ in % Key developments Operating cash flow 1,002 832 20 2,681 2,386 12 ▪ In Q4 2025, operating cash flow strongly increased compared to ▪ Capital ex
Slide 18: FME25+ | Accelerating and extending sustainable savings until 2027
FME25+ | Accelerating and extending sustainable savings until 2027Conference Q4 2024 Call 2021–2027e Sustainable savings in 2026-2027e Planned phasing of FME25+ savings €1,200m €400m in € million Care Delivery ▪ Supply chain optimization 2025 2026e 2027e ~30% ~40% ▪ Clinic footprint optimization ▪ E
Slide 19: Strategic progress in 2025, Q4 2025 business update, Outlook
1 Strategic progress in 2025 2 Q4 2025 business update 3 Outlook
Slide 20: 2026 | Largest product launch in FME history
2026 | Largest product launch in FME history Q4 2024 Conference Call 2026 will be pivotal transition year to execute large-scale 5008X launch in the U.S. FME U.S. clinic conversion Around 20% Up to 17.3m ▪ Large-scale launch of 5008X of machines to units of consumables CAREsystem in FME clinics and
Slide 21: FY 2026 | Outlook & margin assumptions
FY 2026 | Outlook & margin assumptions Q4 2024 Conference Call FY 2026 Revenue and operating income Revenue Broadly flat growth FY 2025 basis: € 19,628 million Implied Group operating income margin 10.5 – 12.0 percent Operating Between positive and negative income mid-single digit percent growth FY
Slide 22: FY 2026 | Outlook assumptions
FY 2026 | Outlook assumptions Q4 2024 Conference Call Revenue assumptions Operating income assumptions Operating income drivers in € million Care Delivery − Normal flu season with same market treatment growth in the U.S. Headwind Tailwind broadly flat and in International with solid growth − Moderat
Slide 23: Aspirations | Industry-leading growth and margins
Aspirations | Industry-leading growth and margins Q4 2024 Conference Call 2028 Aspirations 2030 Aspirations Revenue Care Delivery | low- to mid-single digit percent growth Care Enablement | mid-single digit percent 3 to 7 percent CAGR Excluding Value-Based Care 2025-2030 Group | Mid-teens Operating
Slide 24: Your questions are welcome
Your questions are welcome
Slide 25: Appendix
Appendix
Slide 26: Q4 2025 | Profit and Loss
Q4 2025 | Profit and Loss Q4 2024 Conference Call Q4 2025 Q4 2024 Growth Growth € million € million in % in % cc Revenue 5,070 5,085 0 7 Operating income 594 259 129 144 Operating income margin in % 11.7 5.1 Operating income excl. special items 705 489 44 53 Operating income margin excl. special ite
Slide 27: FY 2025 | Profit and Loss
FY 2025 | Profit and Loss Q4 2024 Conference Call FY 2025 FY 2024 Growth Growth € million € million in % in % cc Revenue 19,628 19,336 2 5 Operating income 1,827 1,392 31 36 Operating income margin in % 9.3 7.2 Operating income excl. special items 2,212 1,797 23 27 Operating income margin excl. spec
Slide 28: Q4 2025 | Reconciliation adjustments
Q4 2025 | Reconciliation adjustments Q4 2024 Conference Call Reconciliation of non-IFRS financial measures to the most directly comparable IFRS financial measures for comparison with outlook Inter-segment Group Care Delivery Value-Based Care Care Enablement Corporate eliminations Q4 Q4 Q4 Q4 Q4 Q4 Q
Slide 29: FY 2025 | Reconciliation adjustments and 2025 base for 2026 outlook
FY 2025 | Reconciliation adjustments and 2025 base for 2026 outlook Q4 2024 Conference Call Reconciliation of non-IFRS financial measures to the most directly comparable IFRS financial measures for comparison with outlook Inter-segment Group Care Delivery Value-Based Care Care Enablement Corporate e
Slide 30: Debt
Debt Q4 2024 Conference Call FY 2025 FY 2024 FY 2023 € million € million € million Debt Short-term debt from unrelated parties 17 2 457 + Current portion of long-term debt 1,596 575 487 + Current portion of lease liabilities from unrelated parties 577 616 593 + Current portion of lease liabilities f
Slide 31: EBITDA
EBITDA Q4 2024 Conference Call Reconciliation of adjusted EBITDA and net leverage ratio to the most directly comparable IFRS financial measures FY 2025 FY 2024 FY 2023 € million € million € million Net income 1,191 741 732 + Income tax expense 321 316 301 − Interest income -70 -72 -88 + Interest exp
Slide 32: Return on Invested Capital (ROIC)
Return on Invested Capital (ROIC) Q4 2024 Conference Call 6.6% 6.1% adj. 5.1% 5.8% 4.5% 5.0% rep. 4.9% 3.9% 3.6% 3.3% 3.5% 2.8% 2020 2021 2022 2023 2024 2025 ▪ ROIC in 2020 excl. the impact of the Latin America impairment (special item) and in 2021 excluding FME25+ (special item) ▪ ROIC for 2020 and
Slide 33: Exchange rates, U.S. dialysis days per quarter, definition
Exchange rates, U.S. dialysis days per quarter, definition Q4 2024 Conference Call Exchange rates U.S. dialysis days per quarter Q1 Q2 Q3 Q4 Full year FY 2025 FY 2024 FY 2023 2025 76 78 79 80 313 €:USD Period end 1.175 1.039 1.105 2024 77 78 79 80 314 Average 1.130 1.082 1.081 2023 77 78 79 79 313 €
Slide 34: Key metrics for Care Delivery and Value-Based Care
Key metrics for Care Delivery and Value-Based Care Q4 2024 Conference Call Care Delivery as of December 31, 2025 as of December 31, 2024 Patients Treatments Clinics Patients Treatments Clinics United States 205,483 31,069,465 2,622 206,436 31,213,447 2,624 Growth in % 0 0 0 International 86,419 13,6
Slide 35: Continuous monitoring of clinical performance to enhance care
Continuous monitoring of clinical performance to enhance care Q4 2024 Conference Call Quality index components Dialysis effectiveness Measures how sufficiently the body is cleansed of waste substances Vascular access Quality index Measures the share of patients who do not receive dialysis via a dial
Slide 36: Segment information of past five years
Segment information of past five years Q4 2024 Conference Call € million; % change year-over-year FY 2025 Growth Growth at cc Organic growth FY 2024 FY 2023 FY 2022 FY 2021 Total Revenue 19,628 2 5 8 19,336 19,454 19,398 17,619 Operating income 1,827 31 36 1,392 1,369 1,512 1,852 Operating income ex
Slide 37: IR event calendar
IR event calendar Q4 2024 Conference Call February March April May June 24 Virtual 02 London 14–15 Hong Kong 05 Virtual 02 Paris HSBC Global Report on Q1 2026: Earnings BNPP Exane CEO Report on Q4/FY 2025: Earnings Morgan Stanley European Investment Summit Release and Conference Call Conference with
Slide 38: Investor Relations contacts
Dr. Dominik Heger Ilia Kuerten Fresenius Medical Care AG Investor Relations Global Head of Investor Vice President Else-Kröner-Str. 1 Relations, Market & Investor Relations Competition, Sustainability | 61352 Bad Homburg v. d. H. EVP Germany ir@FreseniusMedicalCare.com +49(0) 6172-2685-822 +49(0)
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